What you need to know about Broken Heart Syndrome

The idea of dying from a broken heart – a fate mostly associated with fairytales – seems melodramatic and surely unlikely. But the upsetting news in December 2016 that actress Debbie Reynolds had died just hours after her daughter, Carrie Fisher, had also passed away was enough to make anyone recognise it as a very real and terribly tragic occurrence.

Instances of two people who love each other dying in quick succession are actually more common than you might think, and that's because broken heart syndrome (BHS), also known as stress-induced cardiomyopathy or Takotsubo cardiomyopathy, is a real medical condition not dissimilar to a heart attack. To find out more about BHS, its causes and cures, we spoke to Dr Nelson Chong, senior lecturer in pharmacology at the University of Westminster, and Julia Samuel, bereavement counsellor and author of Grief Works.

The cause

"It can be fatal but in most cases improves over time. Although it can develop at any age, it seems to mainly affect women over the age of 50. BHS is usually caused by a surge of stress hormones, such as adrenaline, that can be initiated by an emotionally stressful event like death of a loved one or a divorce, break up or a separation. It could even happen after a good shock like winning the lottery or birthday celebration."

It's a condition that can be misdiagnosed as a heart attack, because the symptoms and some of the test results can be similar. However, Dr Chong adds, unlike a heart attack, there is no evidence of a blocked heart vessel in cases of BHS.

"In BHS, a part of the heart temporarily enlarges and doesn't pump as well, while the rest of the heart functions normally. The most common symptoms of BHS are chest pains and shortness of breath. You may also experience irregular heartbeat (cardiac arrhythmias). You can have these symptoms even if you don't have a history of heart disease."

It is thought that BHS could account for up to 5% of heart cases seen by doctors.

In December 2016 Debbie Reynolds died just hours after her daughter, Carrie Fisher

Ethan MillerGetty Images

The effect

At the moment, there are no known medicines that can treat BHS, but it is important to see your GP if you are suffering.

"Since the symptoms resemble a heart attack, it's vital that you seek immediate medical help," says Dr Chong. "Although the part of the heart that enlarges with the onset of stress can return to normal size in a matter of days, symptoms can remain for weeks or even months."

The physical pain of a broken heart is also something Julia comes into contact with every day as a bereavement counselor. She says:

"For the last twenty five years of working with those grieving the death of someone they love, every single one of them has their version of saying to me 'my heart physically hurts' or 'I feel broken hearted'. This is something that is universal across cultures, gender and religious divides."

We know from neuroscience that our thoughts and feelings are intertwined, to the extent they are referred to as one interconnected unit: 'mindbody'. Statistics back this understanding for it shows, for instance, that surviving partners are 66% more likely to die within the first three months to the first few years after their partner's death.

This is supported by new developments in our current understanding of cellular chemistry and physiology, which show that, when living cells are removed from someone who has been bereaved, they function less effectively than those removed from a person who is not grieving. This further suggests a physical link between grieving and wellbeing although, Julia highlights, this is ultimately a personal process and no two people will grieve in the same way.

"There are certainly no absolutes in grieving, so we need to recognise that some people may be devastated by the death of someone they love, and have no physical symptoms, whilst others like Debbie Reynolds are literally broken hearted and die."

She adds:

"We can aid the healing process by taking the concerns of the bereaved very seriously. If the bereaved can find ways of supporting themselves, it is key in helping them build up their resilience when managing so much pain. In my book I detail eight Pillars of Strength that make a real difference and do concretely help the bereaved. They offer suggestions to find ways of expressing your grief, whilst developing positive habits like regular exercise and meditation that help regulate your body physiologically."

Fun fact: Strong emotion isn't necessarily a negative thing. It's thought that 'happy heart syndrome' – brought on by positive events such as the birth of grandchildren or a milestone birthday – account for roughly 1.1% of all broken heart syndrome cases.

Jenny L. CookJenny Cook is an award-winning writer and editor who covers health and personal finance.

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